The woman, who lacks health insurance, gets help at the clinic from an all-volunteer crew — dentist Sam Roach; his physician-wife, Pam Roach; and Rana Malik, a dental assistant in training.

This charity clinic takes an Arabic name that means the “healing place” and was started in 1998 to serve the growing Muslim immigrant and refugee population. It now serves a number of Spanish-speaking residents as well. It has earned the distinction as one of the few charity clinics in Texas that includes medical and dental care and mental health services.

The load is increasing at charity clinics like this and clinics more narrowly focused on basic medical care.

The Texas unemployment rate fell to 8.1 percent because of new job creation in November. But many new jobs don’t come with health insurance for the patient or carry premiums so high some families perform financial triage, deciding to forgo insurance in favor of food or housing, say clinic and medical trade group officials.

“People may be getting jobs, but they are not getting health insurance,” said Jody Hopkins, the executive director of the Austin-based Lone Star Association of Charitable Clinics.

The founder of the Al-Shifa Medical Clinic is psychiatrist Basheer Ahmed, a native of Hyderabad, India, who came to teach at UT Southwestern Medical School in Dallas. In 1995 as Bosnians and Somalis settled in the area, Ahmed received a phone call to organize help. Soon a help line was established in the garage of his home, and it blossomed into the Muslim Community Center for Human Services.

Within a few years, the center’s medical clinic was added. Muslim women there can expect to have their cultural preference met for female health care providers.

Today, it includes counseling, domestic violence intervention and a dental clinic and draws clients from Fort Worth to Irving and the suburbs in between.

Each new patient is asked to make a $20 donation for medical care. There are discounted fees for some other services such as lab work and dentistry.

The medical clinic alone expects about 1,800 patient visits this year, up from about 1,200 last year. The dental clinic expects about 250 patient visits this year.

Other services have covered about 165 people who came for counseling for domestic violence. Al-Shifa has received a grant for such outreach under provisions of the federal Violence Against Women Act. Inside one of the offices in the medical complex, posters read: “Islam is peace and wife abuse destroys peace.”

Finding volunteers is a specialty for Ahmed, who gives potential recruits from all faiths — Muslim, Hindi or Christian — a “serve humanity” pitch.

“You charge fees, but you are happy to see them get better,” he said. “Here we are seeing people with no money, but you will get more pleasure because they have no other place to go. When you see the appreciation on their face, it will make your day.”

Dr. Pam Roach also said the volunteer work is rewarding. “They are desperate, and you feel you are really giving.”

Her dentist-husband said the need is so high that some patients will have three to five extractions done, if that is what’s called for. Recently, he donated his dental equipment to give a stronger base to the Al-Shifa dentistry practice — one of the more complicated and expensive services for a charity clinic to provide.

Arellano, the Mexico-born patient, gets home care instructions from a Spanish-speaking volunteer. It’s her third visit, she said, adding that the services are “really good,” as she cradles a young daughter in her arms. She looks swollen but relieved.

In Farmers Branch at the Metrocrest Family Services Clinic, another charity clinic, Jane Hawkins praises the work of Al-Shifa. This year, services at Metrocrest jumped to about 4,000 visits from 1,000 last year, after the clinic was funded for a full-time physician under a program known as Project Access Dallas. It is run by the Dallas County Medical Society.

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